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Stigma of Dr. Do-Little Fades From Grenada U.

Seen from the campus here, the Caribbean Sea appears so serene and breathtakingly beautiful that it may be hard to remember that just 15 years ago this month the United States fought a sort of war to save St. George's University.

Some 6,000 troops were sent by President Ronald Reagan to rescue medical students he feared would be taken hostage by a hostile government allied with Cuba. But even in the midst of that conflict, a few soldiers found the setting so congenial that they later returned as students.

For an institution barely two decades old, St. George's University has had a remarkable history. Begun in 1977 and run privately by Americans as an offshore program for aspiring doctors unable to gain admission to American medical schools, it has survived both political turmoil here and skepticism about its quality abroad.

Today, with an enrollment of nearly 2,000, up from 760 during the invasion, St. George's is poised for a burst of growth. The university is building a 45,000-square-foot library, classrooms, laboratories and student housing, the fruits of a $25 million building program.

But the most profound changes have to do with academics. Trying to become a truly Caribbean university, St. George's has begun both a School of Arts and Sciences for undergraduates and a School of Graduate Studies, allowing students to specialize in public health, tropical medicine, anthropology and other subjects of regional interest.

''Because of our attractive location and our diverse student body, we have a unique opportunity,'' said Dr. Peter Bourne, the university's newly appointed vice chancellor and formerly an adviser to President Jimmy Carter on health and science. ''Within 5 or 10 years, we can become the eminent academic institution in the Caribbean.''

The core of the university, though, remains its medical school, which has trained nearly 2,500 doctors. C. V. Rao, the dean of students, who began there as an anatomy professor, recalled, ''We started with 200 students and 5 faculty members, teaching in a wooden hall so small that they had to repeat their lectures, and today we have a faculty of nearly 600.''

Then, as now, enrollment was drawn primarily from students whose grades fell short of what American medical schools were demanding. Though many a B-movie has poked fun at offshore universities as havens for slackers, the truth is that students at St. George's are comparable to those at many American medical schools: the average college grade-point average of enrolling students is 3.4 on a 4.0 scale, compared with 3.56 for those at medical schools in the United States, according to the Association of American Medical Colleges; the average Medical College Admissions Test score of applicants to St. George's is 26 out of 30, compared with 26.5 nationally. St. George's also has a healthy pool of seven to nine applicants for every slot.

''We're the people the U.S. schools didn't want because we didn't quite fit the profile,'' said Christopher McWhorter, 23, a second-year student who graduated from the University of Georgia. ''For the past few years, the bar keeps getting raised higher and higher, so I just decided to go abroad and come down here.''

During St. George's early years, virtually all the students came from the United States or Canada. More recently, the university has stepped up recruiting in Africa and Asia, especially in countries that retain a British educational structure from colonial days and use English as a language of instruction. Since 1993 the percentage of non-American students has increased to more than 1 in 5, from less than 1 in 10; the college is aiming for a 50-50 split. Fifty-nine countries are represented this year.

Studying in an international environment, particularly in a third-world country, has some disadvantages, Mr. McWhorter said, but overall the experience has been better than he had expected.

''It's fun to see the mix,'' he said. ''Just think, last night I was playing cards with students from Iran, which is something that could never have happened if I had stayed back in Georgia.''

To accommodate students of different backgrounds, St. George's has arrived at ''a hybrid medical curriculum'' combining the North American and British systems, to use the phrase of Dr. Allen Pensick, dean of basic sciences. ''We mix problem-solving sessions along with didactic teaching,'' he said. ''For an international student population, we think that approach is best.''

For foreign students, enrolling at St. George's assures clinical tryouts at affiliated hospitals in the United States and Britain, often a prelude to obtaining a residency.

''Coming from India,'' said Ajay Malhotra of Delhi, who attended the State University of New York at Stony Brook, ''it is easy for me to adapt to a place like this, and they have very good board pass rates here.''

Ninety-three percent of St. George's graduates passed the United States Medical Licensing Examination on the first try, in June 1997, a figure comparable to that for graduates of American medical schools and far above the 58 percent rate for graduates of other offshore medical schools. According to St. George's records, 99 percent of its American graduates have been accepted for residencies at 364 hospitals in 41 states, with 21 percent going on to become chief residents, a designation bestowed only on the best.

''Our pass rate is better than some of the Philadelphia schools I couldn't get into, which I guess just goes to prove that grades and MCAT scores have nothing to do with your clinical abilities,'' said Shira Gertz, 23, a Bard College graduate who majored in biology and music and plans to become a neonatalogist.

Like many of the students it attracts, St. George's University has struggled. Two years after the medical school was founded, Maurice Bishop and his New Jewel Movement assumed power on the island in a coup, established a Marxist government and allied with Cuba. The leaders invited the Cubans to build an international airport barely a mile from St. George's main campus.

In October 1983, a more radical faction of the party overthrew and killed Mr. Bishop, which led to fighting and fears that the nearly 1,000 Americans on the island, most of whom had some connection to St. George's, might be taken hostage. After efforts to evacuate the Americans failed, President Reagan ordered ''Operation Fury,'' which took the Cuban forces prisoner, flew the students to the United States and installed a friendly government.

''Within 15 days, we were in Piscataway, N.J., conducting classes at Rutgers Medical School with a new set of cadavers,'' Dr. Rao recalled. The campus here reopened on Jan. 10, 1984, in a significantly changed environment.

''The U.S. Government brought in a lot of aid, and by 1990, people began to look at this as a more stable place,'' Dr. Rao said.

Prime Minister Keith Mitchell, who has been in office since 1995, said the university ''has played an enormous role'' in the development of Grenada, not only providing jobs and tax revenues to the island of 100,000 citizens but also a chance at higher education.

The Caribbean's leading institution of higher education is the University of the West Indies, which is celebrating its 50th anniversary and has campuses in Jamaica, Barbados and Trinidad. But with a population that exceeds 6 million, the English-speaking Caribbean produces 123,000 high school graduates each year, far beyond the capacity of the University of the West Indies.

In the past, many of the region's most promising students have gone on to colleges in the United States, Britain or Canada, swelling the brain drain. But because of recent immigration restrictions -- and limitations on Federal grants to university and medical programs -- ''it is increasingly difficult for students from third-world countries to get into U.S. institutions,'' said Dr. Bourne, chairman of St. George's department of psychiatry before being appointed vice chancellor.

Hence the School of Arts and Sciences, which, like the medical school, has begun humbly, with 196 students, many of them Caribbean residents, who are entitled to a reduced tuition of $4,000 a year, compared with $10,400 for nonresidents. School officials, though, are planning to accommodate 1,000 students in the near future, eventually as many as 5,000. St. George's, which receives no money from the Grenadian government, relies on tuition to operate.

The expansion comes in response to ''a great need to move into areas where we can be of greater service to the Caribbean,'' said George McGuire, associate dean of the School of Arts and Sciences and a former Minister of Education here.

Programs of special interest to the Caribbean, like marine biology and tourism, are under development. And in what the Prime Minister called ''one of the more noble initiatives of the university,'' there is even a new Cricket Academy, intended to train promising West Indian players for international competitions.

''We want to be head and shoulders above everything else in the Caribbean, to cease to be a foreign body in the area and face up to the fact we are a Grenadian institution,'' Dr. Bourne said. ''We are about halfway there, and I suspect that when we get there, there will still be a lot of room for further expansion.''